Bone mineral density in women with asthma on long-term inhaled corticosteroid therapy
Inhaled corticosteroids (ICS) have become first line agents in the management of moderate-to-severe asthma. Long-term use of ICS is associated with decreased bone mineral density (BMD). To investigate the prevalence of BMD loss and its severity in women with asthma on long-term ICS. Fifty-six women...
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| Veröffentlicht in: | Annals of allergy, asthma, & immunology asthma, & immunology, 2000-12, Vol.85 (6), p.495-500 |
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| creator | Bonala, Savithri B Reddy, Byra M Silverman, Bernard A Bassett, Clifford W Rao, Yalamanchili AK Amara, Sreenivasrao Schneider, ArleneT |
| description | Inhaled corticosteroids (ICS) have become first line agents in the management of moderate-to-severe asthma. Long-term use of ICS is associated with decreased bone mineral density (BMD).
To investigate the prevalence of BMD loss and its severity in women with asthma on long-term ICS.
Fifty-six women with asthma on long-term ICS, attending an inner-city allergy clinic were selected to undergo bone densitometry in order to evaluate the association between BMD and the long-term use of ICS at different dose ranges.
Women (60.7%) had decreased BMD either at the lumbar spine or hip region. Among postmenopausal women, 17.1% of those |
| doi_str_mv | 10.1016/S1081-1206(10)62578-1 |
| format | Article |
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To investigate the prevalence of BMD loss and its severity in women with asthma on long-term ICS.
Fifty-six women with asthma on long-term ICS, attending an inner-city allergy clinic were selected to undergo bone densitometry in order to evaluate the association between BMD and the long-term use of ICS at different dose ranges.
Women (60.7%) had decreased BMD either at the lumbar spine or hip region. Among postmenopausal women, 17.1% of those <65 years and 42.9% of those ≥65 years had osteoporosis compared with 5.7% (95% CI–3.9% to 8.5%) of those <65 and 29.3% (95% CI–25.7%–33.5%) of those ≥65 years reported in the NHANES III survey. 1 The prevalence of low BMD increased as ICS dose increased from 5% in the low dose group to 50% in the high dose group (
P < .002). There were significant linear trends of decline by dose in mean BMD for the hip (
P < .001) and the lumbar spine (
P < .002). Women who received medium or high doses of ICS had significantly greater bone loss than those receiving low doses.
The findings of increasing BMD loss with increasing ICS dose reinforce the necessity to monitor BMD periodically in women on ICS, particularly in the high risk postmenopausal group and those on medium to high doses. There should be a concurrent continual attempt to lower the dose by supplemental nonsteroidal controller medications and providing nutritional and pharmacologic treatment of identified BMD loss in these patients.</description><identifier>ISSN: 1081-1206</identifier><identifier>EISSN: 1534-4436</identifier><identifier>DOI: 10.1016/S1081-1206(10)62578-1</identifier><identifier>PMID: 11152172</identifier><identifier>CODEN: ANAEA3</identifier><language>eng</language><publisher>McLean, VA: Elsevier Inc</publisher><subject>Administration, Inhalation ; Adrenal Cortex Hormones - administration & dosage ; Adrenal Cortex Hormones - therapeutic use ; Adult ; Asthma - drug therapy ; Asthma - physiopathology ; Biological and medical sciences ; Bone Density - drug effects ; bone mineral density ; corticoids ; Dose-Response Relationship, Drug ; Drug toxicity and drugs side effects treatment ; Female ; Humans ; inhalants ; Medical sciences ; Middle Aged ; Pharmacology. Drug treatments ; Postmenopause - physiology ; Premenopause - physiology ; Toxicity: osteoarticular system</subject><ispartof>Annals of allergy, asthma, & immunology, 2000-12, Vol.85 (6), p.495-500</ispartof><rights>2000 American College of Allergy, Asthma & Immunology</rights><rights>2001 INIST-CNRS</rights><rights>Copyright American College of Allergy and Immunology Dec 2000</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c416t-33e0f1f61b2754c7b5a4d74b95bfc1c460df0caab0b86c74e16edce50cad0fb3</citedby><cites>FETCH-LOGICAL-c416t-33e0f1f61b2754c7b5a4d74b95bfc1c460df0caab0b86c74e16edce50cad0fb3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/S1081-1206(10)62578-1$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=855018$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/11152172$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bonala, Savithri B</creatorcontrib><creatorcontrib>Reddy, Byra M</creatorcontrib><creatorcontrib>Silverman, Bernard A</creatorcontrib><creatorcontrib>Bassett, Clifford W</creatorcontrib><creatorcontrib>Rao, Yalamanchili AK</creatorcontrib><creatorcontrib>Amara, Sreenivasrao</creatorcontrib><creatorcontrib>Schneider, ArleneT</creatorcontrib><title>Bone mineral density in women with asthma on long-term inhaled corticosteroid therapy</title><title>Annals of allergy, asthma, & immunology</title><addtitle>Ann Allergy Asthma Immunol</addtitle><description>Inhaled corticosteroids (ICS) have become first line agents in the management of moderate-to-severe asthma. Long-term use of ICS is associated with decreased bone mineral density (BMD).
To investigate the prevalence of BMD loss and its severity in women with asthma on long-term ICS.
Fifty-six women with asthma on long-term ICS, attending an inner-city allergy clinic were selected to undergo bone densitometry in order to evaluate the association between BMD and the long-term use of ICS at different dose ranges.
Women (60.7%) had decreased BMD either at the lumbar spine or hip region. Among postmenopausal women, 17.1% of those <65 years and 42.9% of those ≥65 years had osteoporosis compared with 5.7% (95% CI–3.9% to 8.5%) of those <65 and 29.3% (95% CI–25.7%–33.5%) of those ≥65 years reported in the NHANES III survey. 1 The prevalence of low BMD increased as ICS dose increased from 5% in the low dose group to 50% in the high dose group (
P < .002). There were significant linear trends of decline by dose in mean BMD for the hip (
P < .001) and the lumbar spine (
P < .002). Women who received medium or high doses of ICS had significantly greater bone loss than those receiving low doses.
The findings of increasing BMD loss with increasing ICS dose reinforce the necessity to monitor BMD periodically in women on ICS, particularly in the high risk postmenopausal group and those on medium to high doses. There should be a concurrent continual attempt to lower the dose by supplemental nonsteroidal controller medications and providing nutritional and pharmacologic treatment of identified BMD loss in these patients.</description><subject>Administration, Inhalation</subject><subject>Adrenal Cortex Hormones - administration & dosage</subject><subject>Adrenal Cortex Hormones - therapeutic use</subject><subject>Adult</subject><subject>Asthma - drug therapy</subject><subject>Asthma - physiopathology</subject><subject>Biological and medical sciences</subject><subject>Bone Density - drug effects</subject><subject>bone mineral density</subject><subject>corticoids</subject><subject>Dose-Response Relationship, Drug</subject><subject>Drug toxicity and drugs side effects treatment</subject><subject>Female</subject><subject>Humans</subject><subject>inhalants</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Pharmacology. Drug treatments</subject><subject>Postmenopause - physiology</subject><subject>Premenopause - physiology</subject><subject>Toxicity: osteoarticular system</subject><issn>1081-1206</issn><issn>1534-4436</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2000</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkV1rFDEUhoMo9kN_QiW0IHoxmpNJMuOV1FJtodAL63XIJGfclJlkTbKV_ffNdrcWeuNNEl6e83J4QsgRsE_AQH3-CayHBjhTH4B9VFx2fQMvyD7IVjRCtOplfT8ie-Qg51vGGPSqfU32AEBy6Pg--fUtBqSzD5jMRB2G7Mua-kD_xhnr6cuCmlwWs6Ex0CmG303BNFdiYSZ01MZUvI25htE7Wha1Z7l-Q16NZsr4dncfkpvv5zdnF83V9Y_Ls9OrxgpQpWlbZCOMCgbeSWG7QRrhOjF8kcNowQrF3MisMQMbemU7gaDQWZQ1c2wc2kPyflu7TPHPCnPRs88Wp8kEjKusoWcgRcsrePwMvI2rFOpqmjPe9bxnbYXkFrIp5pxw1MvkZ5PWGpjeONcPzvVG6CZ6cK6hzr3bla-GGd3T1E5yBU52gMnWTGMywfr8j-ulrP9Sqa9bCquwO49JZ-sxWHQ-oS3aRf-fRe4BniOeDw</recordid><startdate>20001201</startdate><enddate>20001201</enddate><creator>Bonala, Savithri B</creator><creator>Reddy, Byra M</creator><creator>Silverman, Bernard A</creator><creator>Bassett, Clifford W</creator><creator>Rao, Yalamanchili AK</creator><creator>Amara, Sreenivasrao</creator><creator>Schneider, ArleneT</creator><general>Elsevier Inc</general><general>American College of Allergy, Asthma, & Immunology</general><general>American College of Allergy and Immunology</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7QP</scope><scope>7T2</scope><scope>7U2</scope><scope>C1K</scope></search><sort><creationdate>20001201</creationdate><title>Bone mineral density in women with asthma on long-term inhaled corticosteroid therapy</title><author>Bonala, Savithri B ; Reddy, Byra M ; Silverman, Bernard A ; Bassett, Clifford W ; Rao, Yalamanchili AK ; Amara, Sreenivasrao ; Schneider, ArleneT</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c416t-33e0f1f61b2754c7b5a4d74b95bfc1c460df0caab0b86c74e16edce50cad0fb3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2000</creationdate><topic>Administration, Inhalation</topic><topic>Adrenal Cortex Hormones - administration & dosage</topic><topic>Adrenal Cortex Hormones - therapeutic use</topic><topic>Adult</topic><topic>Asthma - drug therapy</topic><topic>Asthma - physiopathology</topic><topic>Biological and medical sciences</topic><topic>Bone Density - drug effects</topic><topic>bone mineral density</topic><topic>corticoids</topic><topic>Dose-Response Relationship, Drug</topic><topic>Drug toxicity and drugs side effects treatment</topic><topic>Female</topic><topic>Humans</topic><topic>inhalants</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Pharmacology. Drug treatments</topic><topic>Postmenopause - physiology</topic><topic>Premenopause - physiology</topic><topic>Toxicity: osteoarticular system</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bonala, Savithri B</creatorcontrib><creatorcontrib>Reddy, Byra M</creatorcontrib><creatorcontrib>Silverman, Bernard A</creatorcontrib><creatorcontrib>Bassett, Clifford W</creatorcontrib><creatorcontrib>Rao, Yalamanchili AK</creatorcontrib><creatorcontrib>Amara, Sreenivasrao</creatorcontrib><creatorcontrib>Schneider, ArleneT</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Health and Safety Science Abstracts (Full archive)</collection><collection>Safety Science and Risk</collection><collection>Environmental Sciences and Pollution Management</collection><jtitle>Annals of allergy, asthma, & immunology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bonala, Savithri B</au><au>Reddy, Byra M</au><au>Silverman, Bernard A</au><au>Bassett, Clifford W</au><au>Rao, Yalamanchili AK</au><au>Amara, Sreenivasrao</au><au>Schneider, ArleneT</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Bone mineral density in women with asthma on long-term inhaled corticosteroid therapy</atitle><jtitle>Annals of allergy, asthma, & immunology</jtitle><addtitle>Ann Allergy Asthma Immunol</addtitle><date>2000-12-01</date><risdate>2000</risdate><volume>85</volume><issue>6</issue><spage>495</spage><epage>500</epage><pages>495-500</pages><issn>1081-1206</issn><eissn>1534-4436</eissn><coden>ANAEA3</coden><abstract>Inhaled corticosteroids (ICS) have become first line agents in the management of moderate-to-severe asthma. Long-term use of ICS is associated with decreased bone mineral density (BMD).
To investigate the prevalence of BMD loss and its severity in women with asthma on long-term ICS.
Fifty-six women with asthma on long-term ICS, attending an inner-city allergy clinic were selected to undergo bone densitometry in order to evaluate the association between BMD and the long-term use of ICS at different dose ranges.
Women (60.7%) had decreased BMD either at the lumbar spine or hip region. Among postmenopausal women, 17.1% of those <65 years and 42.9% of those ≥65 years had osteoporosis compared with 5.7% (95% CI–3.9% to 8.5%) of those <65 and 29.3% (95% CI–25.7%–33.5%) of those ≥65 years reported in the NHANES III survey. 1 The prevalence of low BMD increased as ICS dose increased from 5% in the low dose group to 50% in the high dose group (
P < .002). There were significant linear trends of decline by dose in mean BMD for the hip (
P < .001) and the lumbar spine (
P < .002). Women who received medium or high doses of ICS had significantly greater bone loss than those receiving low doses.
The findings of increasing BMD loss with increasing ICS dose reinforce the necessity to monitor BMD periodically in women on ICS, particularly in the high risk postmenopausal group and those on medium to high doses. There should be a concurrent continual attempt to lower the dose by supplemental nonsteroidal controller medications and providing nutritional and pharmacologic treatment of identified BMD loss in these patients.</abstract><cop>McLean, VA</cop><pub>Elsevier Inc</pub><pmid>11152172</pmid><doi>10.1016/S1081-1206(10)62578-1</doi><tpages>6</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1081-1206 |
| ispartof | Annals of allergy, asthma, & immunology, 2000-12, Vol.85 (6), p.495-500 |
| issn | 1081-1206 1534-4436 |
| language | eng |
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| source | MEDLINE; Access via ScienceDirect (Elsevier) |
| subjects | Administration, Inhalation Adrenal Cortex Hormones - administration & dosage Adrenal Cortex Hormones - therapeutic use Adult Asthma - drug therapy Asthma - physiopathology Biological and medical sciences Bone Density - drug effects bone mineral density corticoids Dose-Response Relationship, Drug Drug toxicity and drugs side effects treatment Female Humans inhalants Medical sciences Middle Aged Pharmacology. Drug treatments Postmenopause - physiology Premenopause - physiology Toxicity: osteoarticular system |
| title | Bone mineral density in women with asthma on long-term inhaled corticosteroid therapy |
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